Dr OP Yadava
CEO & Chief Cardiac Surgeon, National Heart Institute

National Heart Institute has been strengthening preventive care through various mediums ranging from health awareness sessions to regular checks at all levels of the society. It believes in reaching out to the rural masses to ensure increased public awareness on health, shares Dr OP Yadava, CEO & Chief Cardiac Surgeon, National Heart Institute in an exclusive interview with Elets News Network (ENN)

On the recent 35th foundation ceremony, the National Heart Institute released some of the major eye-opening data related to heart diseases. What major shifts have you witnessed in the released data?

We have noticed that there is 9.74 per cent increase of female patients in the last 4 years in the National Heart Institute. Further, 28 per cent of patients are less than 40 years of age. This thereby clearly shows that lifestyle disorders are definitely on the rise and that women, though less prone to develop coronary artery diseases till menopause, are by no means totally immune and lifestyle disorders do afflict women in significant numbers at a young age too.

Over the last 35 years, what have been the major achievements and areas of improvement of the National Heart Institute?

The National Heart Institute has grown with the ethos of sustainable and community-centric development. It subscribes to the model of earning from a small section of paying patients and using those profits for the benefit of the underprivileged and underserved. Certain major achievements of the National Heart Institute have been:

School Health Programme

Rheumatic Fever PreventionProgramme of 3 weekly injectable penicillin prophylaxis for the prevention of rheumatic heart disease, which has now been adopted internationally

The National Heart Institute is the collaborative centre for preventive cardiology of the World Health Organization (WHO) for Southeast Asia and is also involved in the training of nurses and paramedical staff for the Southeast Asian countries on the behalf of WHO

Free pacemaker bank

Gift of Life programme in collaboration with Rotary International where children are offered free open heart surgeries

The National Heart Institute has awidespread outreach programme, where heart camps are held in remote areas of the country

Setting of a telemedicine Programme between the remote areas of Uttarakhand and National Heart Institute is another feather in our cap

A number of other socially relevant programmes like Vyadhi Nidhi Programme of Uttarakhand Government, Winning Heart Programme and collaboration with Sameer Malik Heart Care Foundation Fund a key project of the Heart Care Foundation of India for treating girls and young women suffering from rheumatic heart diseases.

Specific areas that we want to focus on are taking the tertiary care services to the doorstep of the masses. The corporate hospitals are targeting tier-I and tier-II cities for profit margins, but the National Heart Institute is trying to reach out to the rural belt and take the services to the very doorstep of the masses with the aim of serving the masses. Additionally, the focus wouldbe on health promotion, education and sensitisation of the masses towards health and to bring about a change in the outlook and the mindset of the general public towards health.

How is the National Heart Institute planning to spread awareness about the increased number of cardiac cases? Please provide details.

Health awareness and education of the patients and masses is the forte of All India Heart Foundation (AIHF). It has released a number of booklets and documentary films for the education of the masses. As the clinical research and medical care delivery wing of the AIHF, the National Heart Institute holds regular camps, where preventive screening of blood pressure, blood sugar and other common ailments is done. Besides these, regular lectures are conducted, exhibitions are put up and health films are shown.

Our volunteers also go out to the villages and speak to the small group of people in the language they understand to make the discussion meaningful. Lectures are also held in captive groups like schools and intercolleges. In fact, in Delhi, the National Heart Institute has started a school health programme, which would be covering 100 schools in Delhi in a year. As a part of this initiative, students of class IX to XII would be educated by the experts on the prevention of heart disease from the very onset.

What are the future plans of the National Heart Institute in terms of affordable quality care in the cardiology segment?

The National Heart Institute is setting up a cardiac care unit in collaboration of the Government of Uttarakhand in Base Hospital, Almora with the aim of reaching out to masses. On the personal level, I have set up Uttarayana Hospital in a remote village of Almora district with the aim of taking preventive, promotive, and primary and secondaryhealthcare to people.

The National Heart Institute aims to start satellite centres in remote areas and link them with its telemedicine programme where the focus would be on developing the right attitude to health by holding regular sensitistion and health education camps, and where besides health checks, health education would be the main focus. To make treatment more affordable, use of indigenous products, new techniques in recycling and off-pump techniques are being developed and introduced.

What kind of policy-level changes are required in the Indian healthcare ecosystem to achieve the entire vision of Universal Healthcare?

To achieve universal healthcare, all the stakeholders need to participate equally. However, participation of the public and, more importantly, medical professionals in this effort has been inadequate. The medical fraternity has to take responsibility and each one of us need to spend time in our clinics for health education. Both patient and their accompanying relatives should be sensitised regarding the health.

Also, we need to incorporate our traditional systems of medicine and look at a holistic healthcare model, which is most likely to succeed as these systems have greater acceptability in the public, certainly much more thanallopathy and some of those modalities of treatment, which may not be as well scientifically validated, but originated from wisdom of generations, are highly effective and seem to work for a particular set of population in that geographical ecosystem. So these local micro-health systems should be encouraged and given due importance and if need be, scientific studies should be carried out with due rigour to validate them.

Just as the environment has microclimate, even health has microecosystems, which may vary every 50 kilometres. This fact has been corroborated by the relatively new field of pharmacogenomics. So instead of developing national and international programmes, we need to now visit the small ecosystems and customise the needs of people and match them to the locally available treatment modalities. The physical model of healthcare delivery as postulated by Descartes has failed miserably all over the world and it needs to be complimented with other models, including but not limited to Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). Universal healthcare is a total myth, and the only way we can ever contemplate getting close to it is by preventing illness and promoting health. Additionally, insurance models should be modified so that health promoting activities can become reimbursable.

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